Comparison of Intravenous Ranitidine and Metoclopramide VersusIntravenous Ondansetron in Preventing Postoperative Nauseaand Vomiting Post General Anaesthesia

BACKGROUND AND OBJECTIVES: Postoperative nausea and vomiting (PONV) have forever been a complication of anaesthesia. Lack of efficient prophylactic antiemetic therapy may prove detrimental to a successful surgery and timely discharge. There are a wide range of drugs for preventing PONV. This study was designed to compare the efficacy of intravenous ranitidine plus metoclopramide to that of intravenous ondansetron in preventing post-operative nausea and vomiting in patients undergoing general anaesthesia. METHODS: 84 patients undergoing elective surgery under general anaesthesia were randomized into two equal groups to receive either a combination of 50 mg ranitidine plus 10 mg of metoclopramide or 4mg of ondansetron. Both groups of drugs were given intravenously half an hour prior to induction. All patients underwent standardized general anaesthesia with controlled ventilation. They were monitored at the initial first hour and for 24 hours post operatively for episodes of nausea, retching and vomiting which were tabulated under a scoring system. RESULTS: When considering ranitidine and metoclopramide group: nausea was absent in 71.43% of patients in the initial hour and 90.48% of patients in the 24 hours post operatively. Retching was absent in 90.48% of patients in the initial hour and in 95.24% of patients in 24 hours post operatively. Absence of vomiting was seen in 76.19 % of patients in the initial hour and in 95.24 % of patients in the 24 hours of postoperative period. In the ondansetron group nausea was absent in 71.43 % of patients in the initial hour and in 88.09 % of patients in 24 hours of postoperative period. Absence of retching was seen in 83.33% of patients in the initial hour and in 97.61% of patients in 24 hours of postoperative period. Absence of vomiting was seen in 85.71% of patients in the initial hour and in 92.85% of patients during 24 hours of postoperative period. CONCLUSION: It was concluded from this study that the combination of ranitidine 50 mg, metoclopramide 10 mg was as efficient as ondansetron 4mg when given intravenously prior to general anaesthesia in preventing PONV.